In layman terms, it is a condition where children have abnormal jerky movements, commonly involving the upper and lower limbs while having a fever.
And what would be the symptoms?
A typical febrile seizure would be characterised by the following symptoms:
- Body temperature exceeding 38°C
- Child loses consciousness
- Rhythmic jerky movements of both upper and lower limbs
- Drooling of saliva
- Uprolling of eyeballs
- Bowel and bladder incontinence
- Post-seizure drowsiness (Child asleep after occurrence of seizure)
Febrile seizures have been classified into 2; Simple and Complex. Why is this important?
The types of febrile seizures a child has significantly affects the treatment and future risk of developing epilepsy, as you will read further in this article. Below is a table depicting the differences between a simple and complex febrile seizure.
So, in the scenario of being at home with a sick child, who is suddenly convulsing right in front of your eyes, what should you do?
- First and foremost, do not panic!
- Attempt to carry the child if possible, to a safe place where there’s no risk of the child hitting the head or falling off.
- Position the child on the side as this would prevent the child from choking on their own saliva.
- Never make the child bite on anything as depicted in movies and such, as this could actually present a choking hazard to the child!
- A quick glance at the clock to time the duration of the seizure would be very helpful.
- Next, record a 1-minute long video of the child convulsing. (As weird as this sounds, this would actually be helpful when you visit a paediatrician, as the child would in all likelihood have stopped convulsing, and the paediatrician would be able to make the correct assessment from the video itself.)
- Sponging the child with a wet cloth may help bring the temperature down, but it’s unlikely to stop the convulsions.
An important note to all parents regarding this is that, febrile seizure is a recurring condition, even if it’s a simple febrile seizure. Epidemiological researches have concluded that children who have a first occurrence of febrile seizure at less than 12 months of age have increased risk of recurrent febrile seizures. This recurrence decreases with increasing age, and commonly stops after the age of 5. A simple febrile seizure typically ends way before the 15 minute mark, hence it is okay to find a doctor after the convulsion ends. However, if the seizure lasts for longer than 5 minutes, get to a doctor as soon as possible. This is to rule out other causes of seizures such as meningitis, encephalitis or other causes of childhood seizures.
Debates have been going on for ages whether anti-convulsant drugs should be used for febrile seizures. The general consensus is a NO. Treatment of febrile seizures occurring in children less than 5 years of age are mostly conservative. Paracetamol and sponging are the go-to treatments as most children with febrile seizures stop convulsing after the age of 5.
Do not worry too much over febrile seizure in your child. As long as you do not panic and follow the instructions of the doctor, your child will grow up strong and healthy!
Hussain Imam Hj Muhammad Ismail, Ng Hoong Phak, Terrence Thomas. Paediatric Protocols For Malaysian Hospitals 3rd Malaysia: Kementerian Kesihatan Malaysia, 2016.
Tom Lissauer, Graham Clayden (eds.). Illustrated Textbook of Paediatrics 4th Missouri: Mosby Elsevier, 2012.
by Melvin Lee
A fresh medical graduate balancing life between nerding and being a gym rat. He is passionate about life itself, and believes in living to his fullest in everything he does. His proudest flaw? Coffee addiction. View all articles by Melvin Lee.